Stage 5 Chronic Kidney Disease Definition
Stage 5 CKD is defined as a glomerular filtration rate (GFR) less than 15 mL/min/1.73 m², representing kidney failure. 1
GFR Threshold for Stage 5 CKD
The National Kidney Foundation defines Stage 5 CKD as GFR <15 mL/min/1.73 m², which represents kidney failure and the most advanced stage of chronic kidney disease. 1
Unlike Stages 1 and 2, Stage 5 CKD diagnosis is based solely on the GFR criteria—no additional evidence of kidney damage is required for classification. 1
Stage 5 CKD encompasses both patients with GFR below 15 mL/min/1.73 m² who are not yet on dialysis and those already requiring chronic dialysis therapy. 2
Clinical Context for Your Patient
In patients with diabetes and hypertension (as in your case), reaching Stage 5 CKD represents the culmination of progressive kidney damage, where the kidneys have lost approximately 85-90% of their function. 3
At this stage, kidney replacement therapy (dialysis or transplantation) becomes necessary for survival, as the kidneys can no longer adequately remove waste products and maintain fluid and electrolyte balance. 4
Preceding CKD Stages for Reference
Stage 4 CKD is defined as GFR 15-29 mL/min/1.73 m², representing severe decrease in kidney function. 1
Stage 3 CKD is characterized by GFR 30-59 mL/min/1.73 m², representing moderate decrease in kidney function. 1
Advanced CKD (ACKD) is a term that encompasses both Stage 4 and Stage 5, defined as GFR <30 mL/min/1.73 m². 4
Important Clinical Considerations
Preservation of even minimal residual GFR in Stage 5 CKD is clinically important, as it influences dialysis prescription and patient outcomes. 2
The prevalence of advanced CKD (Stages 4-5) is approximately 0.2-0.6% in the adult population, increasing to 1.6% in persons older than 64 years. 4
All patients with Stage 5 CKD should be under nephrology care, as multidisciplinary management improves outcomes and is cost-effective. 4